Tag: cancer

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Using Both Health Systems in Costa Rica

The public health system in Costa Rica is one of the best in the world, but as in other good systems there are occasionally delays for many reasons with an overload of patients and one always has the option to go to a private doctor at your own expense. Once Covid was over, when I had to use a private oncologist for my surgery and radiation treatment because our hospitals here were packed with Covid patients, I then moved all my medical treatment to the public system in 2022 and have been happy with everything done “for free” (really for a monthly Social Security fee you must pay whether used or not.) There are no co-pays, no insurance forms and everything is included, even my medications that I pick up monthly at my local “CAJA Costarricense Seguro Social Farmacia.” I’m pleased with the public health system here, even if sometimes slow.

My latest cancer surgery was in November with my Public Provincial Dermatologist removing a cancer from my nose. Excellent surgery with absolutely no scar! But, that dermatologist in Hospital San Rafael de Alajuela gave me my next appointment to be in April 2026 and I had other non-cancer issues I really wanted to take care of earlier. So, I decided to exercise my freedom of going to a private doctor and my Public ENT Oncologist at Hospital Mexico de San Jose, who is monitoring any possible spread of my big cancer, agreed that the other issues would be better if handled earlier and he recommended Dr. Arturo Soto in the private Tabush Dermatologia Center in Escazu (feature photo of building). Here is my report with 3 before & after face photos . . .

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FAVE BIRDS: The Next Blog Series + Health Update

Starting tomorrow I am going to share some of my favorite bird photos out of literally thousands of over 350 species of birds here. It has been very difficult to choose just a few favorites. I started with 40 and whittled it down to 21 and gave up after that, so over the next three weeks I’ll be sharing 21 bird photos of 21 different species of birds found here, introducing the species, including a link to the eBird description, a link to my gallery on that species, and I’m writing a “Backstory” about each particular photo I’m sharing. It seems that there is a story behind every photo! 🙂 I hope you will find it interesting and revealing about Costa Rica for both nature lovers and birders! And oh yes, the two bird photos in this post did not make the cut for a feature, so they decorate this post! 🙂

I’m working ahead on the series and trying to make each blog post a visual work of art as well as a valuable chunk of information about a bird species in Costa Rica, including where I found it and which lodge I stayed it. I trust they will become valuable tools for future visitors and new expat residents of Cost Rica, starting tomorrow with the beautiful Resplendent Quetzal!

Yellow-throated Euphonia & the Feature Photo at Top is a Gray-cowled Woodrail

Update on My Health and Latest Cancer Report

First, I recently had the same CAT Scan (called TAC here) they did to diagnose the cancer and it shows me totally cancer-free after the surgery and 7 weeks of radiation. That is good news!

Now the effects of the radiation still have not all gone away and usually do not for about a year for most patients, meaning I may be “normal” by next July. 🙂 The left side of my face & neck + the left ear are all still swollen or enlarged somewhat. That is normal the first year. My smile is almost “normal” now, not totally lopsided on right side only as after surgery. I will always have to deal with my left eye not blinking or being able to fully close. I use eye drops two or three times a day and wear an eye patch most of the time except for about 3 hours in the morning.

I am still low on energy or tired a lot, wanting to sleep more and that is normal for the first year they say. My taste has partially recovered though not totally and they say that can take as much as 6 months to a year to fully recover, so I’m much closer to normal there! Though my appetite is still not high and my weight is still lower than before. I drink an Ensure protein shake once a day to help keep me healthy and otherwise try to eat healthy.

Mentally/emotionally I am fine and generally have a positive attitude about life regardless what is happening. So in short, I’ve made great improvements and I’m overall feeling very well, just not planning as many activities as before. Plus at 81 I needed to slow down anyway! 🙂 And these new series of blog posts using past photos is one example of how I’m slowing down while remaining creative. But I will be adding new trips and new photos, just not as frequently now! 🙂

¿Cómo estás? – ¡Total bien! 🙂 That’s how most people answer here regardless how they really feel! 🙂 The positive and helpful attitudes of Costa Ricans is also healing to me! I’m so glad I live here now!

¡Pura Vida!

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My CANCER Adventure Book

Mostly my real time journal and blog posts plus photos and other information that is meant to be inspirational for someone else going through cancer, especially my specific Parotid Tumor Cancer with 68 pages and 87 photos, including a few of my nature posts during that time. 🙂

I also emphasize the value of nature in healing for me. And the title “True Grit” is explained in the book and on back cover, kind of funny! 🙂

You can see a free electronic preview at https://www.blurb.com/b/10778284-true-grit Or click the cover image below:

Me in front of Radiation Machine on book cover.

You can also browse through all my nature photo books while in the bookstore or click on Bookstore on the menu bar above.

¡Pura Vida!

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These Berries are Ripe . . .

. . . and so am I, almost! I’m redder or pinker now on my face from the radiation 🙂 and also ripe at the point of being almost finished. Today, Tuesday, I lack only 2 more radiation treatments, meaning I’m finished by noon Thursday! Yay! Starting Thursday afternoon I’m home to stay for at least 5 weeks before I have a trip planned. And hoping I have some taste and swallowing ability back by then (the lodge food is said to be excellent!), though my doc says to not count on the taste totally returning that soon. She says it can take up to 6 months for some people to have it totally but gain it little by little, week by week. Since my radiation was only on the left side of my mouth, maybe I will get it back sooner. Hoping! 🙂

The red berries are on the big tree at the hotel that had been yellow berries for weeks but now red, ripe and ready for the birds and other creatures! The blue or black berries below are in a yard I walk by everyday to and from the clinic and Walter, my driver, says they are sweet and if people can pick them before the birds and animals, they add them to dishes for sweetness or just eat as berries.

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June is Cancer Survivor Month

At least that is so in the U.S. that has a month or week for almost everything! 🙂 And surviving cancer is a big deal worth celebrating!

I’m still in radiation therapy through June 10 and to be honest feeling terrible much of the time, tired and especially not being able to eat much with a constant bad taste in my dry mouth most of the time, even gagging on some food – But this too shall pass! 🙂 And now I’ve got pain and drainage in my left ear near the surgery that no one has identified yet. I may go to an ENT independently to see what it is if no answer soon. All that to say it is not always easy, but today one can survive cancer! Celebrate Cancer Survivor Month!

Feature photo is a Hibiscus Flower from one of my walks to the clinic. Flowers say “hope!”

¡Pura Vida!

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Not a Mummy – Me in a “Mask”

I promised somebody I would show what my daily process of a few minutes looks like, as pitiful as I look shirtless. One of the young technicians made these three (requested) shots of me screwed to the table for the radiation treatment. I show up each morning by 11:45 and I’m walking back to the hotel by 12 noon usually. Quick and mostly painless (though the mask is really tight on my face). It appears more scientific than human, but believe me, the staff are all so friendly and nice and do their various jobs very proficiently. And they all shift to English when I walk in, though not their native language. Amazing! And I use my elementary Spanish with them as I am able, though not necessary here like at the public clinics and hospitals.

One outside person told me that this clinic is equal to Mayo Clinic in the states for Radiotherapy. I feel like I’m in very good hands. My radio doctor will conference with me every Tuesday until finished and work with me on any side effects, etc. And a nurse is always there plus other doctors always in the building. A very professional place that in fact does remind me a little of being in the Mayo Clinic with my brother Jerry, just not as big! 🙂

Notice the Screws holding me down with the mask.
Feels like being a mummy! 🙂
Everything must be perfectly lined up for radiation in the right places.

Are we having fun yet? Sure!

3 Days Down and 30 More to Go!

🙂

¡Pura Vida!

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Earth Day Hope

“Wherever there are birds, there is hope.”

~Mehmet Murat ildan

And of course this is just one of the many birds who have brought hope to my terrace here in Atenas, Costa Rica – A Keel-billed Toucan in my Cecropia Tree (link to my Keel-billed Gallery). There is hope that the big rich nations are waking up to global warming and their long-time destruction of our planet. And there’s hope in the battle against my destructive cancer. Below is my update of activities that finally make it possible to begin Radiotherapy Monday.

Second Covid Shot this Morning

Quick and painless. I walk into the temporary vaccination clinic ahead of my 8 AM appointment, paperwork done quickly with shot even quicker and I was out of there before my appointment time. 🙂 I walked home, having taken a taxi to the clinic. With my knee no longer hurting I’m back into walking more and hopefully every day during radiation, though I will have to wear the big wide-brimmed hat they tell me! I must avoid sun during radiation.

Tomorrow Morning Stitches Removed

Tomorrow (Friday) morning at 9 AM I see my Ophthalmologist in San Jose who will remove the two stitches from my left eyelid and supposedly this is going too help me use my left eye for longer periods of time without an eye patch. So far I’ve gone up to 6 to 8 hours at a time without covering it. Reading tires it out more than general activities like kitchen work or even a little TV. I seldom watch more than an hour a day, if that much. For Earth Day I found a special on the internet streaming channel Curiosity Stream for wonderful nature documentaries and signed up for a year at just $10 or $2 more than one month of Netflix here. I will probably drop Netflix again. Seen all their documentaries I care about and the rest is mostly junk.

Got off subject there! 🙂 I assume the eyelid will stay partly closed now when the stitches are removed since she did something to make the top and bottom grow together at one corner. But, FYI, my left eyelid will never blink again or fully close.

UPDATE: 23 April – She did not remove the stitches today. She first said she would remove just 2 of the 3, leaving one to help protect from radiation. But because she used nothing for pain, I flinched and she said she would not remove them at all for now, saying I have a “low tolerance for pain” and I think she has a low sympathy level! 🙂 She was also very painful to me at beginning of surgery. So now she will wait until after radiotherapy and try again in June. Hmmm. 🙂 Permanent stitches? — But the Good News: both eyes are doing very well and she is pleased with the surgery results. I’m already using my left eye more than 6 to 8 hours a day, so progress even if I have a low pain tolerance! 🙂

Radiation Starts Monday

This coming Monday, 26 April, I get my first radiotherapy in San Jose and daily Monday to Friday for six weeks or through June 4. They were not comfortable with all these other overlapping medical appointments plus needed the time this week to prepare for my targeted treatments. She is studying all the reports on both of my left cheek surgeries, the earlier “skin cancer” one and the big one March 15 including biopsies, etc. to help her target all remaining bits of possible cancer. My future is sort of in her skilled hands. 🙂 Dr. Bonilla is both an oncologist and radiologist and my surgeon says the best here.

I’m still bargaining with hotels near the radiation center but hoping for the Best Western with four nearby restaurants and hope to schedule that today. I plan to spend Monday to Thursday nights there and back in Atenas Friday-Sunday nights. I will be giving regular updates from San Jose starting next week which I hope will be interlaced with some nature reports also! 🙂

¡Pura Vida!

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Don Carlos

The honorific title of “Don” (“Doña” for older women) started in Europe for royalty and leaders of honor in Spain, Italy and Portugal, while today in Latin America it is a term of respect and endearment for senior adults. Since I started my cancer treatments, most of the different doctor offices call me Don Charlie, Don Charles or now my oncologist office lady always calls me Don Carlos. It is kind of nice to have the respect shown and helps to keep you from feeling sorry for yourself. 🙂 Respect for the elderly in Cosat Rica is everywhere!

Report on Today’s Two Doctor Appointments

Like with so many doctor appointments, both gave follow-up appointments with the biggest being with my Ophthalmologist who is doing minor outpatient eye surgery on my left eye this Friday right after the dentist appointment. It is one of her standard procedures to partially close the eyelid that won’t blink or close on its own. It will be down to a kind of permanent squint so the eye doesn’t dry out and water so much like now AND most likely I will no longer need to wear an eye patch! AND I will be able to see with both eyes (particularly helps depth perception). Both eyes are still 20/20 vision so I still don’t need glasses, though over-the-counter reading glasses (magnifying) is okay and sometimes needed for someone my age. I’ve especially needed them while reading with one eye only the last couple of weeks. And maybe the best part, her special ophthalmology operating room is in Ciudad Colon on the Atenas side of San Jose, meaning a shorter drive! 🙂

It was important to squeeze this in before radiation starts to avoid more damage from the radiation. It is like they are rebuilding my body.

And the oncology surgeon just checked the incisions and swelling which is visibly going down now, but can take a month or more. This skin is less and less sensitive in that area. But it could take up to a year before back to “normal.”

¡Pura Vida!

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Another Gauntlet of Doctors

This happened the week before my cancer surgery and now it has started again two weeks before the beginning of my radiation treatments – tiring – hard to keep up with – but necessary!

1. Today, First of 3 Dental Appointments

Those who have experienced radiation know that you cannot have any dental work done after radiation for a long time, especially no tooth pulled because the radiation does something to keep the hole from a pulled tooth from healing. Hopefully none will need to be pulled! 🙂

  • Today (Monday) – teeth cleaned and checked out with two tiny cavities found visually that she will fill this Friday. She also ordered a panoramic X-ray of my teeth from the Dental Radiologist one block away where I went next to make my appointment.
  • Thursday – Teeth X-rayed when I will take the resulting X-ray back to Dr. Karina for her to study and see if there are other problems we should take care of before radiation.
  • Friday – I return to Dr. Karina for the two known fillings and anything else she finds on the x-rays.

2. Tomorrow, Tuesday – Appointment with Ophthalmologist

This is Dr. Raquel Benavides whom I saw in the hospital and Dr. Hernandez (my oncology surgeon) recommends to see if anything can be done to help my eyelid that will not close now or blink. He thinks she can “stich” the eyelid mostly closed to a sort of squint so that I will not have to keep it covered and can still see with it. Hmmm, I’m not convinced of that yet but maybe she will convince me or have some other solution other than an eyepatch. I’ll find out tomorrow and expect almost anything to come after radiation is completed.

3. Tomorrow, Tuesday – Appointment with Oncology Surgeon

This will be my 3rd “follow-up” or “post-op” visit to the surgeon, Dr. Christian Hernández. He wants to check on the healing of the long incision and the swelling on my left face and neck. Plus he said he wants to hear what the Ophthalmologist says. 🙂 He must not have a mouth specialist friend who can fix one-sided smiles! 🙂 He encouraged me earlier to go ahead and shave on the left side, but because it is tender and sensitive I only lightly run the electric razor over the left cheek and even more lightly on the left side of my neck which is more swollen and more sensitive. So I am not back to normal yet, skin-wise. The pain is less now in the ear and jaw, but still some and I’m now taking an over the counter acetaphetamine locally popular called Panadol.

4. Wednesday – Seeing my Dermatologist as Pre-scheduled

The last time I saw him, Dr. Roberto Gamboa, was when he sent me to Dr. Hernández to take care of the tumor which I will now have to tell him came from that skin cancer he removed in MOHS surgery which is supposed to mean they got it all. Well . . . cancer roots go deep! At that last visit he also treated a little skin cancer on my upper lip which was a black spot on my lip in some of my cancer selfie photos. (I was putting a very expensive anti-cancer medication on it once a day for 20 days.) That scab is gone now and supposedly the little cancer there. Of course he will be checking for any more and he often burns bumps off my skin with nitrogen. He is also my “traveling buddy” who likes nature lodges all over Costa Rica like me. He is the one who recommended Bosque del Cabo Lodge where I’m going the first week of July and earlier got me hooked on El Silencio Lodge I’ve visited twice now! Hopefully he finds no new skin cancers this visit. And maybe the best thing is that he is located in nearby Alajuela rather than far-away San Jose! 🙂 A much quicker and easier drive!

5. Next Monday – MRI at the Lindora Campus of Hospital Metropolitano

This MRI is for the Radiotherapists to help them target the cancer cells in my head, especially in the nerves since the cancer was in the left facial nerve. The best thing about this is that it is in a suburb on this side of San Jose, Lindora, and secondly in the only hospital that takes my Medismart Card for a big discount, as does the Radioterapia Siglo XXI I’m using and thus they are sort of Medismart partners. 🙂 It will take only about an hour with a little less than an hour each way traveling, so not as tiring as going to San Jose.

6. Next Tuesday – CT Scan and Mask-making at Radioterapia Siglo XXI

I assume that the MRI and CT Scan show different things that they need, thus I’m getting both in preparation for the radiotherapy. Both of these will be in San Jose at the Radioterapia Siglo XXI building where I will spend a lot of time the next month and a half.

7. Begin Radiotherapy in San Jose

This is the long-haul treatment of cancer, radiotherapy 5 days a week for 6 weeks and they guarantee that you will be tired at the end – enough so that they encourage you to plan no activities for the following 4 week or in my case, the month of June. It will take place in central or north-central San Jose at Radioterapia Siglo XXI, the only private radiation company in Costa Rica with only one place for the public healthcare patients to get it at Hospital Mexico. I chose to pay for private because it could be quicker, with often very long waits in the public healthcare system and because my oncologist strongly recommended it because of the size of the cancer.

As I shared in an earlier post, I am now planning to travel to San Jose each Monday and return to Atenas on Fridays, staying in a hotel near the therapy location. Even though someone else will be driving, I dislike the long, high-traffic drive that at peaks can be 2 hours between Atenas and San Jose. As long as I feel like it, I will even add a tour or two each week to something of interest in San Jose like some wonderful museums and parks plus history and architecture that interests me and may give photo ops, though many museums restrict photographs. Otherwise I will be pampered with all meals, room cleaning, Wifi, and hotel gardens to relax in between treatments. I will try to turn radiation into a relaxed and colorful, tropical vacation in the center of Costa Rica! 🙂

¡Pura Vida!

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Radiation – The Next Adventure

For the last few days or so everything has been a “moving target” for me with an initial consultation with the radiation doctor explaining everything medically and checking me out and now we are putting a plan together with her staff and on the calendar, plus I’ve arranged to pay for it. And oh yes, this doctor is a specialist in radiation to the head and neck! 🙂 Hopefully my surgery neck swelling will soon be gone and the tender scars on my left face and neck healed better than they are now. I’m still sore and sensitive with only minor internal pain that I treat with Ibuprofen. They prefer these surgery “irritations” gone before they create new ones with radiation! 🙂

Below is their 3-step plan AND

“My Plan to Make it Fun.” 🙂

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